Gender-Affirming Care: How Facial Feminization Surgery and the 46 Days Since Have Been

I had a dude face. Thus, since I’m a woman (of transgender experience), I didn’t like the misalignment. And it made me not pass worse. And so I got facial feminization surgery* (after it fell through a few times).

I had to make a flurry of calls the business day before surgery day in order to make sure that painkiller medications were lined up. I just had an intuition that not all were ready. (Two of four weren’t.) And then I had to walk in rain more than 80 minutes round-trip in order to get the medications. And I stayed up all night long to ensure that I would arrive to the hospital. Early.

Morning-of, I took a rideshare to Southern California Hospital at Culver City. (Ironically, that’s the hospital where a doctor around June refused to refer to me in female pronouns. Despite my hospital profile and wristband saying I’m female.)

I had to be there by 5:30 a.m. I got there at 5 a.m. The first photo below (the photos are in chronological order) shows me at around that time.

(Note on photos: I could not wear makeup on surgery day and have been apprehensive about applying and removing it in the wake of the surgery.)

After a wait, I was taken to one of those medical rooms where patients are separated by curtains. All the anesthesiologist told me is that he would put me to sleep and then I would wake up.

(That was extremely different from the anesthesiologist for my breast surgery. He told me details about what he would do. And I’ve been told that other anesthesiologists went into details about what they would do to patients before their gender-affirming procedures.)

Radika, the tech for the surgeon, Dr. Alexander Sinclair, braided my hair and made it tight to my scalp. (See the next photo below.) This was the second time my hair has been done by a woman (or anyone) aside from in a salon (which I’ve done three times). I have felt immense happiness both times in doing this girl thing. And I knew that Radika was doing it for the purpose of surgery preparation.

And then it was off to the room where the surgery took place. Maybe the last sentence should have ended in an exclamation point, but I was calm as I lay on the surgery bed/table, right before I went to sleep.

After I woke up, I was desert-level parched. (My mouth had been open during the course of the surgery — Sinclair reached my skull through my mouth.) And an average of every 45 minutes for the next handful of hours, a nurse had to feed me water. That’s because I remained thirsty but too immobile to give it (or anything to drink) to myself. I also thought it was crazy that blood was coming out of my cheek and into a device.

Other than that, I was in and out of sleeping.

I got flowers for myself for surgery day. And they were in water. Getting them to the hospital, from one room to another, and then back home was actually somewhat of a challenge. But despite the nurse’s best efforts, the daisies got something I didn’t — the ability to drink the whole time.

As planned, I stayed at the hospital overnight.

The next morning, I felt absolutely horrible and that the surgery isn’t worth it if you don’t in your depths want or need it. And I thought it was too bad that people think I and other transgender folks think we are going for attention.

Since my hairline was brought forward, blood went over my whole scalp. That was clear given that my scalp was covered in dried blood when I woke up.

I forgot my painkillers and had to get a ride back to the hospital to retrieve them. (A woman named Rez had committed to driving me back if necessary, aside from driving me back home from surgery. She did the latter but not the former. I thus had to find someone else to drive me back.)

The self-adhesive bandaging fell off about 2.25 days after my head was wrapped in it. But during those 2.25 days, I looked like this:

I was concerned that the bandaging being on for a short time could result in problems. But Sinclair told me to just come to the follow-up appointment the next week. All did turn out fine in that department.

Everything else, including the white material under the bandaging, gradually fell off over the eight days. (More fell off on days four, five, seven and eight, specifically. On the eighth, the device on my nose fell off. And everything came off except for tape along the top of my nose, which lingered longer, until day 27.) It resulted in staples in my head being exposed to the public for two to five days. However, it’s fine, since they needed to remain.

As of day 31, my nose still bled in an effort to clear my nostrils congested as a result of the surgery. Most of my nose was still tender.

My face is very much chipmunk-and-chin right now because my cheeks swelled due to the surgery. And my chin was made longer.

I remember feeling my chin a day-and-a-half after surgery. I was amazed at how it kept going and going in feeling where it previously ended and then went from there.

The results went according to plan, though. I’m fine.

As a result of the surgery, I have eight scars on the inside of my mouth. But I don’t care.

The cheeks will mellow out. And overall, my face will look better and more feminine as I heal over the next 10.5 months. (Sinclair gave that timeframe.)

I was so happy when feeling undersides of my new upper halves of cheeks for the first time.

The curly hair and braids done to enable the surgery actually brought me substantial euphoria — I hadn’t had either before. (I was over the moon on Jan. 30, when I first saw the largest braid in the mirror.) I was upset because I undid the first two or three braids before realizing the hair I could have had.

I have a prominent scar along the top of my forehead. It’s a result of Sinclair bringing my hairline forward. I noticed on day 43 that it was already 100% a scar. Skin grafts should take care of the problem.

I still haven’t worn a headband or hat or even done bangs in front of the scar. That’s because being this fresh from surgery, I don’t want anything to touch it yet, even though it clearly is completely a scar.

Because of the anesthesia, I still can’t feel any of the tip of my nose and directly under my lower lip. And if I were to truly try to open my mouth as wide as possible, I would need to be rushed to a hospital. (As of day 31, I could open my mouth three-quarters of a wide but still-normal circumference.)

And generally, the anesthesia still is impacting my chin, eyebrows where they are thinner, the area between my nose and upper lip and more than 80% of my lower lip.

My skull hurt twice when I accidentally hit it twice. However, the healing process has otherwise not been problematic.

As happened twice the week of Dec. 10, I walked down the street with long hair and boots, my long legs going, and I felt like a babe with my hair bobbing up and down. Then I saw myself in the mirror.

As the healthcare industry generally understands, I needed this surgery.

I had been misgendered just about every day since being 100% out in Nov. 2022. Even though I have had the appearance of breasts and hips that entire time.

Even though this doesn’t address my problem of being 6'7", as the healthcare industry generally understands, I need facial feminization surgery.

On Feb. 20, I had remarkably high euphoria in looking at a post-surgery photo of myself — and the final results indeed won’t come for 10.5 more months.

*The surgery included work on my jaw, eyebrows, shape of my eyes and upper half of my nose. Those are besides the hairline, upper-cheekbone and chin work.

• I got a brow lift
• My eyes were made more cat-like
• The upper half of my nose was thinned
• And the upper cheekbones were made more prominent

The day of the surgery, things I thought about included the following:

• Having told my dear friend Carla Long the month I accepted myself that life is crazy.
• Crying while watching YouTuber Ashley Adamson, after hearing her story, say, “I’m a her,” as she cried. (Adamson is a woman who is transgender.)

• Feeling joy while listening to the JURASSIC PARK theme after having attended a South Valley (Utah) Unitarian Society service. I was out at that service as a woman who is transgender after having been part of the congregation in the past.
• Having played “Let it Go” on loop for 85% of nine straight days, while mentally preparing to come out.
• The chills I got throughout my whole body the literal second after Marvin Bagley, the Utah sixth district court presiding judge, made the gender-affirming order.
• The first profound experience I had showering with breasts (one of two as of mid-October).
• Each of 321 anxiety experiences or panic attacks where I felt separate from my body. Including a couple of times when my body felt physiologically on fire in wanting a female body. (Those such experiences or attacks ended two weeks after I started feminizing hormone replacement therapy.)
• When my head hit my pillow twice in four days in late August or early Sept. 2022, I said “I’m a woman?” out loud. (Even though no one else was there.)

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